中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
Chinese Journal of Evidence-Bases Cardiovascular Medicine
2015年
5期
644-646
,共3页
扩张型心肌病%心室重构%QT离散度%螺内酯%美托洛尔
擴張型心肌病%心室重構%QT離散度%螺內酯%美託洛爾
확장형심기병%심실중구%QT리산도%라내지%미탁락이
Dilated cardiomyopathy%Ventricular remodeling%QT dispersion%Spironolactone%Metoprolol
目的：探讨多重阻滞剂联用对扩张型心肌病心力衰竭患者心室重构及QT离散度（QTd）的影响。方法选自2011年3月~2014年12月间在延安市人民医院心内科住院，经保守治疗的扩张型心肌病心力衰竭患者80例。根据随机抽签原则分为治疗组与对照组各40例，治疗组男性21例，女性19例，平均年龄为（56.87±4.11）岁；对照组男性19例，女性21例，平均年龄（56.98±3.89）岁，对照组给予常规纠正心力衰竭（心衰）药物治疗，治疗组在此基础上联用螺内酯与美托洛尔等多重阻滞剂治疗，均治疗14d。结果14d后对照组的有效率为80.0%，治疗组为97.5%，治疗组明显高于对照组（P＜0.05）。两组治疗后的左室舒张末内径（LVEDD）和左室收缩末内径（LVESD）值明显减少，而左室射血分数（LVEF）明显增加，与治疗前比较，差异有统计学意义；治疗组的LVEDD、LVESD与LVEF值与对照组比较，差异有统计学意义（P＜0.05）。两组治疗后QTd值都呈现明显下降趋势（P＜0.05），治疗组QTd值明显低于对照组（P＜0.05）。结论多重阻滞剂联用在扩张型心肌病心衰患者的应用可有效逆转心室重构，缩短QT离散度，提高总体治疗疗效。
目的：探討多重阻滯劑聯用對擴張型心肌病心力衰竭患者心室重構及QT離散度（QTd）的影響。方法選自2011年3月~2014年12月間在延安市人民醫院心內科住院，經保守治療的擴張型心肌病心力衰竭患者80例。根據隨機抽籤原則分為治療組與對照組各40例，治療組男性21例，女性19例，平均年齡為（56.87±4.11）歲；對照組男性19例，女性21例，平均年齡（56.98±3.89）歲，對照組給予常規糾正心力衰竭（心衰）藥物治療，治療組在此基礎上聯用螺內酯與美託洛爾等多重阻滯劑治療，均治療14d。結果14d後對照組的有效率為80.0%，治療組為97.5%，治療組明顯高于對照組（P＜0.05）。兩組治療後的左室舒張末內徑（LVEDD）和左室收縮末內徑（LVESD）值明顯減少，而左室射血分數（LVEF）明顯增加，與治療前比較，差異有統計學意義；治療組的LVEDD、LVESD與LVEF值與對照組比較，差異有統計學意義（P＜0.05）。兩組治療後QTd值都呈現明顯下降趨勢（P＜0.05），治療組QTd值明顯低于對照組（P＜0.05）。結論多重阻滯劑聯用在擴張型心肌病心衰患者的應用可有效逆轉心室重構，縮短QT離散度，提高總體治療療效。
목적：탐토다중조체제련용대확장형심기병심력쇠갈환자심실중구급QT리산도（QTd）적영향。방법선자2011년3월~2014년12월간재연안시인민의원심내과주원，경보수치료적확장형심기병심력쇠갈환자80례。근거수궤추첨원칙분위치료조여대조조각40례，치료조남성21례，녀성19례，평균년령위（56.87±4.11）세；대조조남성19례，녀성21례，평균년령（56.98±3.89）세，대조조급여상규규정심력쇠갈（심쇠）약물치료，치료조재차기출상련용라내지여미탁락이등다중조체제치료，균치료14d。결과14d후대조조적유효솔위80.0%，치료조위97.5%，치료조명현고우대조조（P＜0.05）。량조치료후적좌실서장말내경（LVEDD）화좌실수축말내경（LVESD）치명현감소，이좌실사혈분수（LVEF）명현증가，여치료전비교，차이유통계학의의；치료조적LVEDD、LVESD여LVEF치여대조조비교，차이유통계학의의（P＜0.05）。량조치료후QTd치도정현명현하강추세（P＜0.05），치료조QTd치명현저우대조조（P＜0.05）。결론다중조체제련용재확장형심기병심쇠환자적응용가유효역전심실중구，축단QT리산도，제고총체치료료효。
Objective To investigate the influence of multiple blockers combination on ventricular remodeling and QT dispersion (QTd) in patients with dilated cardiomyopathy (DCM) and heart failure (HF).Methods The patients (n=80) were chosen from Mar. 2011 to Dec. 2014, and randomly divided into treatment group (n=40, male 21, female 19 and average age=56.87±4.11) and control group (n=40, male 19, female 21 average age=56.98±3.89). The control group was treated with anti-HF drugs and treatment group was additionally treated with spironolactone and metoprolol for 14 d.Results The effective rate was 80.0% in control group and 97.5% in treatment group (P<0.05) after treatment for 14 d. LVEDD and LVESD decreased significantly and LVEF increased significantly in 2 groups after treatment (P<0.05). LVEDD, LVESD and LVEF had statistical difference between 2 groups (P<0.05). QTd had a significant descending trend in 2 groups after treatment (P<0.05), and was lower significantly in treatment group than that in control group (P<0.05).Conclusion The combining administration of multiple blockers can effectively reverse ventricular remodeling, shorten QTd and improve the total curative effect in patients with DCM and HF.
